INITIAL INTAKE - UNMARRIED PERSON 
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Email *
What is your first and last name?  (List the first name you like to be called.) *
What is your phone number?
In what city and state do you reside? Not your mailing address, but where you physically reside.  (Reminder that I only service Western WA. The specific counties are listed on the Home page of my website.) *
Have you lived in the state of Washington continuously for at least the last two years? *
Required
What is your marital status?  (If you are married, even if separated, go back to my website and click on the "Married/Separated Person Filing" button.) *
Required
If you have ever been divorced:  Does your *Divorce Decree* say that YOU are responsible to pay any debts that have your ex-spouse's name on them?  Either directly or indirectly?  Or did you incur any debt to your ex-spouse as part of the divorce other than child support or alimony?  
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If you have ever filed a bankruptcy before:  When was it FILED? (Not discharged, but FILED.) *
Required
If you answered the previous question that your previous bankruptcy was filed LESS THAN eight years ago:  What CHAPTER was it that you filed?  
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If you answered the previous questions that a previous bankruptcy was filed LESS THAN eight years ago:  On what DATE was it filed?  
How many people TOTAL live in your household, including yourself?  Include every single person who lives under the roof, even if not a dependent.   *
In general, no need to name names, who are the other people who live in your household? For example spouse, your children, other people's children, boyfriend, girlfriend, parents, roommates, etc.  IF CHILDREN - LIST THEIR AGES.

If any of your other household members are adults:  Do they contribute to the mortgage, rent, utilities, groceries, or other joint household expenses?  Do they give you any money for room, board, food, etc.?  If yes, about how much per month on average?  An estimate is fine. 

If you have a job (not self-employment, but an actual, W-2 "job" working for somebody else):  What are your approximate gross wages (not take home, but gross) from your job?  For example, "$2,500 every two weeks," or "$2,500 twice per month," or "$875 per week," or "$55,000 per year straight salary," or "$17.48 per hour."  Do NOT include overtime, bonuses, commissions, or tips.  
If you listed an hourly wage in response to the question above:  Approximately how many "regular" hours per week do you work on average?  (If you did not list an hourly wage in response to the question above leave blank or type "N/A."
If you have a job (not self-employment, but an actual, W-2 "job" working for somebody else):   Do you ever get overtime, bonuses, commissions, or tips?  If you do, about how much money do you gross per week, month or year on average from just the overtime, bonuses,  commissions, or tips?  Please state the approximate amount and whether it is overtime, bonuses, commissions or tips.

If you have lost a job during the last six months:   What was your gross income (not take home, but gross) from this job?  Please state a number and state whether this is per hour/# of hours, every two weeks, per month or per year. Include bonuses, commissions, and tips.

If you have received unemployment benefits during the last six months:  What is/was your weekly gross unemployment benefit?  

If you have received FMLA during the last six months:  Approximately how much money total have you received in FMLA during the last six months?

If you have a “side-gig” like driving for Uber or anything else you do for money:  What is it that you do AND how much money do you make every month or every year, on average?  (Specify if you are listing monthly or annual amount.  Do not deduct your expenses.)

If you own a business as a sole proprietor:  What is the name AND nature of the business?

If you own an LLC or corporation:  What is the name of the business?

If you are a sole proprietor or own an LLC or corporation:  Is your business currently operating, or have you stopped operating?  

If you are a sole proprietor or own an LLC or corporation:  Do you want to close the business, or keep it going? 

If you are a sole proprietor or own an LLC or corporation: Do you currently have any employees?

If you are a sole proprietor or own an LLC or corporation: If you are still operating, about how much money do you "gross" per year? (“Gross" means the total amount of money you bring in before you deduct any expenses.)

If you are a sole proprietor or own an LLC or corporation: If you are still operating, about how much are your annual expenses?  (Do not count income tax or self-employment tax you need to pay.)  
If you own any sort of business:   Are there any business assets? Such as tools, vehicles, supplies, inventory, etc.?  Please answer "yes" or "no."   If yes, what is the approximate value of the assets?  (If you were to sell them.) 
If you RECEIVE child support or spousal maintenance:  How much do you receive per month?
If you PAY child support or spousal maintenance:  How much do you pay per month?
Do you receive VA disability, Social Security retirement, Social Security disability, or any other money from Social Security? *
Required
If you receive a monthly pension or other non-Social Security retirement money:  What is the gross monthly amount?
If you receive private disability income (not Social Security disability):  What is the gross monthly amount?
In the last six months, if you have received income from any other source in addition to your "normal" sources of income:  Approximately how much did you receive?  (Examples include money from selling something, gift money from family or friends, gambling winnings, etc.)
If you OWN your residence (where you or your dependents actually, currently live):  Approximately how much could it be sold for?  (Check here: www.zillow.com.)
If you OWN your residence (where you or your dependents actually, currently live):  Approximately how much do you owe on it?  List the grand total of first mortgage, second mortgage, home equity line of credit.
If you OWN your residence (where you or your dependents actually, currently live):  Approximately how much are you BEHIND on your payments, if at all? State the dollar amount.
Not counting your residence, if you own any real estate anywhere in the world, (for example rental property, vacation property, a property you own where family member are living, etc.):  How much equity do you have in this property?
For each car, truck, motorcycle, boat, RV, trailer, camper, etc. you own, whether it is fully paid for or not,  please list the year, make & model.  If you do not have a vehicle please type "None."
For EVERY vehicle listed in your previous answer, how much is it worth?  A guesstimate is fine.  If you have no idea just Google it!  Or do a Kelly Blue Book, "Private Party" value.  (You must answer this question for EVERY vehicle you listed above.)
For EVERY vehicle listed in your previous answer, list the balance of any loan.  Include "regular" vehicle loans and any other loans if the vehicle was used for collateral.   (Not the monthly payment, but how much total you owe on the loan.) If there is no loan, type "paid in full."  
Not counting retirement accounts, and not counting money you currently have to pay this month's living expenses, do you have "other money" in the bank, in a safe, under the mattress, set aside, etc.?  If yes, about how much do you have? *
Not counting retirement accounts such as 401(k) and IRA's, do you have investments, stocks, bonds, mineral rights, anything like this?  If yes, what is it and about how much is it worth?  Ballpark guesstimate is fine. *
Do you own any items of personal property that are very valuable/expensive?  In the thousands of dollars?  Big diamonds, jewelry, antiques, paintings, collections, anything? If yes, what is it and about how much is it worth? *
Is there anything you can sue anybody over, or make a claim against, even if you do not plan to?  Such as a car accident, medical malpractice, wrongful termination, anything?  If yes, please state in a nutshell what type of potential claim it is and how much money you think it is worth.  (It does not matter if you want to pursue a claim or not, just provide an honest answer.)  *
Does anybody owe you money?  Do you have any money coming to you?  If yes, about how much?  (List even if you think you will never get the money back.)  *
Are the any lawsuits, garnishments, judgments against you, anything like that?   *
Required
If you owe the IRS any money:  For which tax years do you owe? *
Required
If you owe the IRS any money:  About how much do you owe grand total?
If you currently have student loans:  Approximately how much grand total do you owe?     (Note:  If the ONLY reason you may want to file a bankruptcy is to try to wipe out student loan debt then I am not the right lawyer for you.  I would be happy to refer you elsewhere.)
If you currently owe money on tickets, fines or tolls:  About how much do you owe?
Do you currently owe money on a DUI or anything criminal in nature? *
Required
If you added up all of your unsecured debts (such as credit cards, medical bills, payday loans, broken leases, vehicle repossessions, things like that,) in what range do you think your grand total would be?  $10,000?  $50,000?  $100,000?  Just a ballpark guesstimate is fine.   (Do not count mortgages, vehicle loans, student loans or taxes.) *

If there are any cosigners on any of your debts, contracts or leases, know that the bankruptcy will not wipe it out as to them, so they will still be on the hook.  Your bankruptcy filing may hit their credit report.  They will be notified that you filed for bankruptcy.  Are you okay with  all of this?  (Note:  This only applies to actual cosigners.  It does not apply to "authorized users."   If you have "authorized users" on credit cards you can simply remove them before you file your bankruptcy.)

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OPTIONAL:  If there is anything you would like to tell me feel free to do so below.
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